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108 Cards in this Set
- Front
- Back
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four portals of entry of toxic exposure
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ingestion
inhalation surface absorption injection |
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most common route of entry for toxic exposure
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ingestion
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a poison that is easily absorbed through the skin
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organophosphates
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Antidote for acetaminophen
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N- Acetylcysteine
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Antidote for Atropine
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Physostigmine (also known as eserine) is a parasympathomimetic, specifically, a reversible cholinesterase inhibitor
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Antidote for Benzodiazepines
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Flumazenil
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Antidote for Carbon monoxide
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O2
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Antidote for Cyanide
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Amyl nitrate
Sodium nitrite sodium thiosulfate |
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Antidote for Methyl alcohol
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ethyl alcohol
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Antidote for Nitrates
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methylene blue
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Antidote for Opiates
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Naloxone
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Antidote for Organophosphates
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Atropine
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symptoms of cyanide poison
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cellular asphyxiant
burning sensation in mouth H/A confusion, combative Hypertension and tachy Seizures and coma Pulmonary edema |
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how do nitrites remove cyanide from the blood
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converts some hemaglobin to methemoglobin and cyanide binds to it, Thiosulfate then binds with cyanide and deactivates it
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what would multiple patients living together ina apoorly heated and vented space having flulike symptoms alert you to
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Carbon Monoxide poisoning
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Symptoms of CO poisoning
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H/A
N/V altered LOC Tachypnea |
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symptoms of cardiac medication OD
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N/V
H/A pulmonary edema hypotension bradycardia / heart blocks |
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antidote for calcium channel blockers
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calcium
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antidote for beta blockers
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glucagon
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antidote for digoxin
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Digibind
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what is the PH of strong acids
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less then 2
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what is the PH of strong alkaline agents
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>12.5
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common forms of alkaline and acid agents
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Drano or Luquid plumber
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Describe a strong acid burn
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produces immidiate and severe pain
results in tissue coagulation and necrosis which acts like a shield to stop burning |
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Describe a strong Alkaline burn
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pain is oftern delayed
they produce Liquefaction necrosis which causes deep burns |
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symptoms of caustic injury
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facial burns
pain in the lips tongue throat or gums drooling, trouble swollowing hoarseness, stridor or shortness of breath shock |
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Will Acids or Alkalis absorb
activated charcoal |
NO!! so dont give it
rapid transport... |
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what is Hydrofluoric acid used for
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glass etching
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what is special about hydrofluoric acid
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it is extremely toxic and can be lethal despite the appearance of only moderate burns to the skin death has been reported from <2.5 BSA
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What will inactivate hydrofluoric acid and why is that bad
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cations such as calcium which is leeched out of bones and causes total disruption of cell function
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symptoms of hydrofluoric acid exposure
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burning at the site
trouble breathing confusion palpitations muscle cramps |
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what special treatments would be good for hydrofluoric acid
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irrigate the affected area
Immerse the affected limb in iced water with magnesium sulfate, calcium salts, benzethonium chloride |
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treatments for injestion of hydrocarbons
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gastric lavage can be useful
BUT REMEMBER CHARCOAL WILL NOT BIND TO HYDROCARBONS |
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Symptoms of Tricyclic Antidepressants
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dry mouth, blurred vision
Urinary retention, Constipation, Confusion, Hyperthermia, Respiratory depression, Seizures,Tachycardia and hypotension, HEART BLOCK, WIDE QRS TORSADE DE POINTES |
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what are the most common cause of death in tricyclic antidepressants
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cardiac dysrhthmias
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If you had a benzodiazapine overdose mixed with tricyclic antidepressants would you use Flumazenil
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NO it could cause seizures
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What could be a good treatment for tricyclic antidepresants
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sodium bicarbonate
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What do MAO inhibitors do
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they inhibit the breakdown of neurotransmitters such as epi and dopamine and increase the availability of components needed to make even more neurotransmitters
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Symptoms of MAO inhibitors
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H/A, agitation, restlessness, tremor
Nausea, palpitations, tachycardia, hypertension, hyperthermia, then coma |
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What is the antidote for MAO inhibitors
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THERE ARE NONE
just treat the S/S |
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What kind of drugs are
trazodone-wellbutrin-paxil-zoloft-luvox |
these are selective serotonin reuptake inhibitors
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what is Lithium used for
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treatment of bibolar disorder
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Symptoms of Lithium O/D
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thirst/ dry mouth
tremor/muscle twitching/N/V bradycardia and dysrhythmias |
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Will activated charcoal bind to Lithium
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NO !!
but sodium bicarb may be an option, dialysis is usually needed |
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what are Salicylates
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this is ASPIRIN
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What do salicylates do to the body
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they inhibit normal energy production and acid buffering ing th body resulting in metabolic acidosis
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How much salicylates is neede to cause toxicity
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300 mg/kg
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what would the appropriate treatment be for Salicylates overdose
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Activated charcoal
IV wide full Open sodium bicarbonate for urine alkalinization |
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at what range is acetaminophen toxic
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150 mg/kg
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treatment for acetaminophen
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mucomyst but usually given on clinical an laboratory studies
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when can injestion of iron become toxic
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20mg/kg
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can activated charcoal be used in iron overdose
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NO!!!!
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treatments for iron overdose
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gastric lavage is an option
and Deferoxamine binds to iron so that less is taken up by the cells |
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what is exotoxin
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a soluble poisonous substance secreted during growht of bacterium
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what is a enterotoxin
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an exotoxin that produces gastrointestinal symptoms and diseases such as food poisoning
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what is Clostridium botulinum
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this is the worlds most toxic poison in food
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symptoms of food poisoning
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N/V diarrhea
abdominal pain facial flushing RESPIRATOR DISTRESS IN SEAFOOD POISON OR BOTULISM |
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What are two deadly mushrooms
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Amanita and Galerina these belong to the deadly cyclopeptide
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what is the mortality rate of eating deadly mushrooms
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about 50%
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symptoms of poisonous plang ingestion include what
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excessive salivation, lacrimation, diaphoresis, abdominal cramps, N/V diarrhea, decreased LOC, coma
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what are hymenoptera
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wasps, bees, hornets and ants
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what appears after a bite of a brown recluse spider whith in minutes
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small erythematous macule surrounded by a white ring forms
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what are the symptoms of a brown recluse spider over 8 hours
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localized pain, redness and swelling develop
tissue necrosis, chills, fever, nausea nd vomiting and joint pain. AND DIC |
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what is Disseminated intravascular coagulation
DIC |
this is a bleeding disorder when blood starts to coagulate throughout the whole body, which depletes the body of platlets and coagulation factors which will increase the risk of hemorage
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what does the black widow spider look like
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orange hourglass marking on her black abdomen
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what does the venom of the black widow spider cause
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excessive neurotransmitter release at the synaptic junctions
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Symptoms of a black widow spider bite
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pain and redness and swelling
muscle spasms of all large muscle groups, siezures, paralysis and decreased LOC |
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what are a couple of good treatments for a black widow spider bite
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Diazepam 2.5-10mg IV
or Calcium gluconate 0.1/kg of 10% IV solution |
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what kind of scorpion can kill you
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the bark scorpion
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Symptoms of a scorpions attack
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acts on the nervous system producing a burnign and tingling effect without much evidence of injury initially
progresses to numbness, slurred speech,twitching, |
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treatments for scorpions attack
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constricting band no tighter than a watchband,
Do not use analgesics |
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what are the two family of snakes found in the US
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Pit vipers and
coral snakes |
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name some common pit vipers
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cottonmouths
rattlesnakes copperheads |
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describe a corral snake
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it is a small snake
round eyes and narrow head and not pit has yellow banded red and black rings around its body |
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what is the mnemonic used to determine lethal coral snakes
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red touch yellow kill a fellow
red touch black venom lack |
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what does the bite of a pit viper do to you
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venom contains hydrolytic enzymes that destroy proteins
this may affect the blood clotting system and produce necrosis |
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what can a severe pit viper bite result in
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death from shock in 30 min
but most deaths occure within 48 hours 90% anyway |
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what is the snake bite treatment for a pit viper
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keep patient supine
immobilize the limb maintain the extremity in a neutral position O2 and fluid |
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what will a coral snake bite result in
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its neurotoxin primarily effects the neruo tissue which results in respiratory and skelital muscle paralysis
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what is the treatment for a coral snake bite
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wash the wound with copious amounts of water and apply a compression bandage and keep the extremity at the level of the heart
imobolize O2 and IV |
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describe the poisonous toxins of marine animals
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they are ustable and heat sensitive, heat will relieve the pain and inactivate the venom.
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what is a huge consideration with marine animal attacks in the water
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both fresh water and salt water containg a huge bacterial and viral population beware of maring aquired infections
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drug overdose refers to what
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poisoning from a pharmacological substance in excess of that usually prescribed or that the body cna tolerate
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Benzodiazepines are used to treat what common drugs that are abused
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Cocaine
Amphetamines hallucinogens |
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what do you do for a benzodiazepine over dose
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Flumazenil
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alcohol over dose may require what
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Thiamine and D50W for hypoglycemia
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Alcohol causes what
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CNS depression and slurred speech
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barbiturates cause what
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lethargy
respiratory depression and slurred speech |
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Cocaine causes what
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Euphoria
Dialated pupils Chest pain |
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Narcotics such as heroin and codeine cause
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CNS depression
Constricted pupils hypotension respiratory depressoin |
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marijuana causes what
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Euphoria
dry mouth Dilated pupils |
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Amphetamines cause what
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Exhilaration
Dilated pupils Hypertension |
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Hallucinogens like LSD and PCP cause what
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Psychosis and Dilated pupils
and hallucinations |
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Sedatives like valium cause what
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Altered mental status adn hypotension
brady respiratory depression |
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benzodiazepines cause what
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Altered mental status
slurrd speech Dysrhthmias |
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what is the most common substance of abuse in the us
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alcohol
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how many poisonings occur annually
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4 million
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what is the most common route of entry for toxic exposure
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inhalation
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In cases of poisoning a patient history is hard to obtain because of what
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deliberate deception
patient misinformation drug induced confusion |
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describe the epidemiology of toxic emergencys
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The frequency of toxicological emergencies continues to increase
70% of acccidental poisonings occur among children 6 or younger serious poisonings in older children may represent intentianil poisoning Adult poisonings and OD account for 95% of fatalities in this category |
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In a toxic emergency should you delay transport or support to call poison control
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NO
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What is the most common route for a toxic substance
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ingestion
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What are the 3 principles of decontamination
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reduction of intake of toxin into the body
reduction of absorption of toxin already in the body Increase in elimination of toxin from the body |
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In a toxicological emergency
the physical exam has what two purposes |
documenting physical evidence of intoxication
detect any underlying illness or condition that might affect either patients symptoms or outcome of exposure |
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what are the typical signs an symptoms of carbon monoxide poisoning
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headache
nausea and vomiting confusion ans altered mental status |
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an external pacing device may be needed for what kind of overdose
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cardiac medication
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Describe MAO inhibitors
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treat depression
narrrow index do not eat cheese and wine s/s may appear late in od |
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Describe DTs
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develope 2 or 3 days after the last drink
decreased loc with hallucinations Do not occure with binge drinking |
